The Prostate Cancer Foundation has accepted the view of an influential committee that a national screening programme is premature, but is encouraging it to support pilot programmes in two locations.

The Foundation met recently with the National Screening Advisory Committee, and acknowledged the Committee’s 2023 assessment of insufficient evidence for national screening.

“While we agree about holding off on a national screening programme, we believe the time is right to run pilots in Tairāwhiti and Waitematā and we presented strong evidence to support our view,” said Prostate Cancer Foundation President Danny Bedingfield.

“We hope the committee takes this new evidence into account in deciding whether to support pilot screening, as a matter of urgency.”

The committee of health experts and patient representatives, which acts as an independent advisor to the Health Minister and Health New Zealand Te Whatu Ora, meets up to three times a year.

“New Zealand could prevent hundreds of deaths annually if it adopted a screening programme, but due to the current inconsistent availability and capacity restraints nationally of both healthcare professionals and medical equipment essential to the prostate cancer diagnostic pathway, a full national screening programme is unlikely to succeed at this time,” Bedingfield said.

“However, that shouldn’t hold back pilots of screening, which could be conducted now in two selected locations with minimal extra assistance.

“Over 700 men died of prostate cancer last year and, due to an ageing population, forecasts show that higher numbers will die this year and next. The sooner we have a screening programme, the more lives we can save,” said Bedingfield.

Bedingfield said National screening may be off the table for now, but that doesn’t mean it’s okay to do nothing.

"We must lay the groundwork now for a programme targeting men over 50 who are most at risk of having or developing prostate cancer. Pilots would provide the lessons and data on how to build any future national programme."

Assisted by a prominent urology researcher, Netherlands-based Professor Roderick van den Bergh, the Foundation urged the committee to support the pilots, in which men over 50 would be tested to discern abnormal levels of an enzyme which indicates potential prostate problems which could be cancer.

“On behalf of the 4000 men diagnosed with cancer and the many who don’t yet know they have this life-changing symptomless disease, we’re grateful to the committee for agreeing to meet with the Foundation. It shows that the committee is professional and willing to engage in these difficult, emotional, life-and-death conversations,” Bedingfield said.

The Foundation wants the government to fund two pilots costing $6.4 million in total over four years. Lessons would inform a national screening programme to detect prostate cancer while it was still treatable, reducing the number of deaths.

“Many dads, sons, and brothers have prostate cancer but don’t know it yet. Everyone agrees that early detection leads to better clinical outcomes. This is why we have screening for other deadly cancers in the bowel, cervix and breast,“ said Bedingfield.

“And with an aging population, the number of deaths and cases of prostate cancer is expected to rise. The government needs to take urgent action and support the early detection pilots.”

The committee said in November last year that prostate cancer screening met only two of its eight criteria. The rest were “inconclusive” and it therefore did not support national prostate cancer screening, a view cited by Health Minister Shane Reti in his decision not to support screening.

At the first meeting with the committee, the Foundation said it did not agree with the committee’s inconclusive assessments and offered to fill any gaps in the committee’s knowledge.

“If there is any evidence required, we urge the committee to ask us,” said Bedingfield. “We can find it or seek help from our international networks. It’s important that decisions are fully informed.”

The campaign for screening was bolstered recently by the support of the Urological Society of Australia and New Zealand, which made submissions to Parliament saying there is plenty of evidence from large trials in Europe that prostate cancer screening significantly reduced mortality from the disease, has a massive impact on male mortality, and would help reduce health outcome disparities between Māori and non-Māori.